2023/2024 Product Program Caregiver Responsibility Agreement

Thank you for supporting your Girl Scout’s participation in Girl Scouts of Northern California’s (GSNorCal) entrepreneurship development product programs—the Fall and Cookie Program. The submission of this form provides permission to participate for the 2023/24 program year.

Submission is required for your Girl Scout to voluntarily participate in both the 2023 Fall Take Action and 2024 Cookie Programs. If the Girl Scout’s participation is supported by multiple households, each household adult must submit a Caregiver Responsibility Agreement.


By signing below, I understand and agree to the following:

  • My Girl Scout is a registered member of GSNorCal for the 2023/24 membership year.
  • My Girl Scout has permission to voluntarily participate in the GSNorCal Product Programs, reminder, participation is encouraged, but not required.
  • My Girl Scout and I will model commitment to the Girl Scout Promise, Law, and philosophy at all times.
  • I accept personal responsibility for all products and money my Girl Scout receives and agree that GSNorCal reserves the right to take appropriate collection action to secure payment.
  • I understand that I am not expected to ‘pre-pay’ for product ordered by my troop.
  • I will request and retain a receipt each time product is received and money is turned in to my troop.
  • I agree that only Girl Scouts sell Girl Scout products. Family members, friends, and businesses may not sell Girl Scout products.
  • My Girl Scout will not sell to the public prior to published program dates.
  • My Girl Scout will sell products at the retail prices set by GSNorCal.
  • My Girl Scout will have adult guidance at all times when participating in the programs, in-person, online, including social media and follow all safety guidelines.
  • I will communicate routinely with troop regarding unsold items and additional items requested, as needed.
  • All donations accepted during each program’s dates will be applied toward the program’s Care to Share service project per IRS regulations.
  • I will ensure that 100% of the revenue collected for products my Girl Scout receives is submitted to the troop by the program due date(s) or GSNorCal will add an additional $35 processing fee to the balance owed by the troop.
  • I will ensure my Girl Scout shares her reward choices by the program’s due date(s) and agree that choices not indicated by this date will default to the Reward Card at that level.
  • I understand my Girl Scout's reward choices will be delayed until her balance for product programs is paid in full.  

Caregiver/Girl Information and Agreement


Electronic Signature

Published 07/29/2022

* Please Note: Once you submit this form, you'll have the option to print the form contents on the following page.
Girl Scouting builds girls of courage, confidence and character that make the world a better place.  2014 Girl Scouts of Northern California